The long term goal of this project is to establish the usefulness of needle torque measurements for the diagnosis and monitoring of connective tissue pathology associated with chronic musculoskeletal conditions treated by manual therapies. This project will combine technologies developed in our previous research and technological transfer programs which 1) showed that rotation of ultra-fine acupuncture needles causes winding of connective tissue measurable as increased needle torque and 2) suggest that needle torque may be abnormal in the presence of connective tissue fibrosis or inflammation associated with chronic musculoskeletal pain. Thus, needle torque has the potential of becoming a useful in vivo minimally invasive tool to investigate, diagnose and objectively document improvement in tissue pathology in response to manual therapies. Our Specific Aims are: 1) Design and fabricate a new automated instrument capable of rotating acupuncture needles under computer control, while simultaneously measure needle torque (Auto-NTS); 2) Understand the sources of variability associated with torque measurements in humans without musculoskeletal pain. We will obtain estimates of different sources of variability in measured torque [inter- subjects, intra-subject (across location) and intra-location (across right and left sides)] obtained with the Auto NTS, compared with that of the Manual NTS in 30 human subject without musculoskeletal pain. In contrast to the Manual NTS, the Auto-NTS will deliver a controllable amount and speed of needle rotation. We also will examine the relationship between measured torque and subject characteristics such as age, sex, body mass index and subcutaneous tissue thickness. Understanding the sources of variability associated with needle torque measurements in humans without musculoskeletal pain is an important first step to developing a new research and diagnostic tool that will potentially enhance the practice of manual therapies via: 1) improved understanding of therapeutic mechanisms, 2) optimization of treatment protocols and 3) objective documentation of clinical responses to treatments. Chronic musculoskeletal pain is the source of considerable disability, work absenteeism and health care costs. A major obstacle to the incorporation of manual therapies such as massage and spinal manipulation into our health care system is the lack of methods to objectively measure the effect of treatments. The new Needle Torque Sensor technology that will be developed in this project will potentially allow measurement of connective tissue abnormalities associated with musculoskeletal pain. This will 1) help establish the efficacy of manual treatments through improved research, 2) enhance the objective monitoring of patient progress in clinical practice and 3) bolster the evidence needed to justify insurance reimbursement. [unreadable] [unreadable] [unreadable] [unreadable]